Individual provider Active NPI

Joseph N Young, M.D.

  • Internal Medicine Physician
  • Lakeland, FL
National Provider Identifier
1639276157
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME46003 Issued in FL
Practice address
4237 S Pipkin Rd
Lakeland, FL 33811-1442
Phone
(863) 701-2470
Fax
(863) 701-2474
NPI assigned
Sep 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME46003 FL Primary

Addresses

Primary practice location

4237 S Pipkin Rd
Lakeland, FL 33811-1442

Mailing address

4237 S Pipkin Rd
Lakeland, FL 33811-1442
Phone (863) 701-2470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161228002086 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8123210770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME46003FLMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1639276157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4237 S PIPKIN RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111442",
            "telephone_number": "863-701-2470",
            "fax_number": "863-701-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4237 S PIPKIN RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111442",
            "telephone_number": "863-701-2470",
            "fax_number": "863-701-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOSEPH",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-19",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME46003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.